Open AccessBone Morphogenic Protein (rhBMP‐2) Repair of Alveolar Clefts
Author(s) -
Wudel Justin M.,
Valdez Sondra,
Perkins Jonathan N.,
Blanchard Ashley,
Allen Gregory C.
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451438a11
Subject(s) - medicine , dentistry , alveolar ridge , bone grafting , dental alveolus , bone morphogenetic protein , retrospective cohort study , resorption , surgery , implant , biochemistry , chemistry , gene
Objective An alternative to autogenous bone grafting for maxillary alveolar cleft repair is the application of recombinant human bone morphogenic protein in a collagen sponge matrix. Our aim was to quantify bone growth, examine parental satisfaction following the procedure, and evaluate dental/orthodontic outcomes for patients who underwent rhBMP‐2 alveolar cleft repair. Method A retrospective review was performed on all patients who underwent alveolar cleft repair at a tertiary children’s hospital from 2007‐2010. Satisfaction questionnaires were completed by parents, dentists, and orthodontists. Degree of bone fill was determined by independent grading of postoperative Panorefilms. Results Thirty‐two of the 42 patient cohort had postoperative Panorefilms. Independent grading demonstrated 36.7% had >75% of the alveolar cleft filled, 47.8% had 50%‐75% filled, and 17.3% had <50% filled. Mean length of follow‐up was 24.4 months. One minor complication of bony overgrowth into the nasal cavity was reported. Parent and patient satisfaction regarding surgical outcome was 93.3% and 83.3% respectively. Of dentist respondents, 77.8% reported that the bone quality and alveolar ridge mucosal repair allowed for dental treatment. Of orthodontist respondents, 87.5% reported the graft enabled treatment, and 68.7% felt the graft prevented tooth root exposure and resorption. Conclusion Alveolar cleft repair using rhBMP‐2 provides adequate bone growth to support dental and orthodontic treatment with minimal complications, while alleviating the need for autogenous bone grafting and its morbidity. In addition, the majority of patients and parents are highly satisfied with the surgical outcome.